AMSUS Sustaining Members Meeting for 2 June, 2015
Meeting called to order @ 0800 with welcome from Chairperson, Russ Castioni.
Treasurer/Secretary Kathleen Farrell was present.
Russ began the meeting with an introduction of past Chair Howard Crawford who presented a gift to
Diane Condrick.
Mike Cowan, AMSUS Executive Director, spoke about the annual AMSUS meeting that will include VA,
MHS, Wounded Warrior and Secretary Woodson. He encouraged all to participate.
Russ opened the meeting with the reading of the anti-trust laws. Russ reminded members that the
treatment of our speakers as our guests is to be professional, courteous and respectful that they have given
their time. Each SM has an opportunity to be heard, but time is limited and comments and questions
should not monopolize too much time.
Russ provided a brief introduction to recent SM survey providing clarification on meeting schedule
(introducing new format, business meeting in a.m.), schedules and prior commitments of our sustaining
members and confusion of AMSUS sponsored awards, white paper that Admiral Cowan will lead and
speaker challenge – use AMSUS to get speakers, Admiral Cowan is willing to help. The Bylaws will be
reviewed via committee that Vice Chair Mike Flowers will be assigned as lead.
Secretary/Treasurer Kathleen Farrell read financials with commitment to SM to be more specific on funds,
balance, costs to members.
Balance as of Dec 2014 - $73,738.12
Deposits - $12,400.00
Disbursements - $13,567.44
Balance as of March 2015 - $72,570.68
AMSUS-SM Business Section began with committee reports
Marcus Farbstein – Legislative Committee
The House Armed Service Committee will not pursue an overhaul of the Tricare Health program in the
fiscal 2016 defense bill. The President’s budget for the VA for 2016 is requesting $168.8B which is a 7.5%
increase over 2015.
340B
HRSA submitted their proposed guidance to OMB on May 6.
It is expected to include Definition of Patient, Contract Pharmacy Compliance, Hospital Eligibility,
Manufacturer Refunds, Manufacturer Pricing Oversight and penalties for manufacturer non-compliance.
Expect publication for comment in the next 30-60 days.
Me space just released its latest report to congress.
Guest Speakers portion of the meeting included:
MG Jimmie Keenan introduced by Mark Suckle
Patrick Sculley introduced by Russ Castioni
BREAK
AMSUS-SM Business Section continued:
Doug Remeikis – VA Committee (Jay Price contributor)
Joe Canzolino (VAPBM) – will be encouraging greater VPE access to industry at their upcoming meeting.
Reported VA VPE retirements coming this year: Carl Hensley V23, Roy Coakley V8. Pharmaceutical
prices moved from PBM to the NAC
website. http://www1.va.gov/nac/index.cfm?template=Search_Pharmaceutical_Catalog. VA VISN’s
will be reduced by at least 3 according to the PBM. There will probably be more VISN mergers.VA NAC
– Contracting – if you initiate a TPR and want pricing hidden – Make sure the FSS MOD goes in with
individual branches i.e. VA, DOD, IHS boxes checked separately vs. BIG4 box.
Thanks to Jay Price for the following:
Secretary McDonald directed the establishment on five VA regions to synthesize economies of
scale for the three VA Agencies (VHA, VBA and NCA) as well as to streamline operations and
create a single point of contact for Veterans. The Secretary also directed that the new Regional
structure maintain the integrity of a state as all states have State Department of Veterans Affairs
which provide additional benefits and counsel to Vets.
The creation of five VA regions was directed by the Secretary of the Veterans Administration
Honorable Robert McDonald in late 2014. The structure of the five regions was to be initiated
by 1 June 2015 and the five primary geographies initially advised as the HQ locations for the
regions included; Philadelphia, Atlanta, Indianapolis, Denver and San Francisco.
A link to the regional map is as follows:
http://www.va.gov/opa/publications/docs/myva-5-regions-map.pdf
At this time there is significant uncertainty as to the outcome the regional structure will have on
the VISNs and VPEs. It is believed through non-attributional sources that the most likely
outcome with the VISNs and VPEs is to reduce VISNs to no more than fifteen. As there are
several VPE positions open and/or preparing to open it is believed that the open/soon to be open
positions will not be backfilled. Additionally, it is believed that several of the current VISNs will
combine (2&3, 21&22, etc...).At this time there is not a firm published date which the
uncertainty of the VISN/VPE alignment into the Regions will be resolved.
Dan Remund – DoD Committee
The Defense Health Agency Pharmacy Operations Division South (DHA POD South) is the new name for
the DHA Pharmacoeconomic Branch. DHA POD South relocated from Old BAMC at Fort Sam Houston to
the Lincoln Center. The new address is:
7800 IH-10 West, Suite 335
San Antonio, TX 78230
Express Scripts, Inc. (ESI) began operating under the TPharm4 contract on May 1, 2015. Under the new
contract, MTF claims processing and prospective drug utilization is performed by ESI (under the previous
contract, these function were performed by the Pharmacy Data Transaction Service (PDTS) which is
operated by Emdeon). ESI also established a new select specialty retail pharmacy network comprised of:
 CVS
 Walmart
 Rite Aid
 Target
DoD’s cost for compounded prescriptions rose tenfold between 2012 and 2015 and are on pace to reach
$2 billion in FY 2015. DHA POD and ESI implemented an enhanced claims screening process for
compounded prescriptions on May 1, 2015. While preliminary data (5 days) showed a significant
decrease in costs, expenditures for compounded prescriptions were still predicted to average $145
million per month ($1.7 billion annually). The DHA Director decided to approve implementation of the
ESI commercial reject list for compound prescriptions in an effort to control costs to a greater degree.
The FY 2015 National Defense Authorization Act (NDAA) directs that beginning on October 1, 2015, the
TRICARE pharmacy benefits program shall require eligible covered beneficiaries generally to refill nongeneric prescription maintenance medications through MTF pharmacies or the TRICARE Mail Order
Pharmacy (TMOP). This essentially extends the provisions of the TRICARE for Life (TFL) Pharmacy Pilot
Program to all TRICARE beneficiaries.
Mark Suckle – Capital Equipment Committee
Mark Suckle – Vital Images
Mollie Beaver – Siemens
Lee Ellenberg - Phillips
Phil Goodridge - GE
Vitoria Hibbits - McKesson
March 30 Meeting at VA Central Office
Jan Fry- Deputy Assistant Secretary for Acquisitions
Norb Doyle – Director of Procurement –
VHA, Craig Robinson, Steve Thomas, Kurt Finke, Ron Jenkins
Items Discussed:
(1) High-tech medical equipment consolidation process
a. Current state
b. Turn around down to 8 months from 34
c. Emergency Waiver Consolidations
(2) VHA Standard Operating Procedures
a. Draft SOP and Directive presented
b. Comment period through May 30th
c. Clarifies the complete process for HTME Purchases
d. Includes vendor days – due diligence
e. Emergency consolidation clarification
i. outline when buys will occur
ii. announce close dates and that a final decision has been made
(3) PACs procurement
a. Issues
i. length of time to get the RFPs
ii. number of changes
iii. length of time to get delivery order
iv. disjointed process
v. access
vi. process does not seem to be standardized
b. Next steps
i. create a directive
ii. education
(4) Cybersecurity
a. Timeframe – this is in process and committee is reviewing.
b. If something has been DOD certified, does it have to go back through the process
Russ Castioni, Chairperson and Kathleen Farrell, Secretary/Treasurer presented AMSUS survey
results and introduced meeting format changes to include full breakfast with business meeting in
a.m., total meeting will be half day. Russ and Kathleen encouraged all SM to invite speakers and
play larger role in acting as “speaker liaison”. The meeting adjourned at noon.